7 minute read
CONVERSATIONS WITH WOMEN IN GI
Aasma Shaukat, MD, MPH, FACG, on “Being a VA GI Section Chief”
By Jill Gaidos, MD, FACG
AAFTER PARTICIPATING IN THE PANEL DISCUSSION FOR THE “CAREER OPPORTUNITIES FOR WOMEN IN GI” LUNCHEON
at the ACG 2016 Annual Scientific Meeting, Dr. Shaukat and I sat down to talk about her road to becoming a Veterans Affairs Gastroenterology Section Chief and her responsibilities in that position.
How long have you been Section Chief for the Division of Gastroenterology and Hepatology at the Minneapolis VA Medical Center?
AS: For the last four years.
How big is your GI section?
AS: Our section grew. It went from four physicians to 10.
Do you have a lot of nurse practitioners?
AS: There are 10 physicians and five Advanced Practice Providers.
Prior to becoming the Section Chief, were you full-time at the VA with an academic appointment at the University of Minnesota or part-time at both?
AS: I started as full-time VA, and then the university contracted the VA for my time. The university and VA do different things in different places in terms of how they share FTE because of the way the benefits are structured. The university doesn’t give benefits to anybody who’s not full-time. So, it’s beneficial to be full-time in one place. I did clinic and endoscopy at the university, also have a university appointment, and was also involved with Fellows’ training and education. I went back and forth between the University and VA, but was still full-time VA. That was beneficial because I could apply for a VA career development award and I could also apply for the University’s K award. So, that opened up more opportunities for research funding.
Was that beneficial for your career, to have some academic time and some VA time?
AS: It was, because I see different populations and that gives me a really good perspective. In terms of outpatient clinic, the university has a different kind of population, so I see a more complex patient population who has been referred to a tertiary care facility. And, I got an opportunity to work with fellows in both settings, where I could teach them a lot about system-based practice, how to apply the same evidence, or do the same kinds of things for patients in different settings based on resources. So I think it is beneficial.
You had clinic and endoscopy at the University of Minnesota. What were your responsibilities at the VA?
AS: I had clinic and endoscopy at the VA as well. I also served as the Associate Program Director for the GI fellowship for four years. The Program Director was very busy, so I pretty much ran the fellowship. That’s something that I had an interest in and got involved when I first got there. You always can benefit from a fresh pair of eyes. I said, “So, you guys don’t really do a journal club? How about I do a series of small talks on critical appraisal of literature, of RCTs, comparative studies, systematic reviews, cost-effectiveness analysis, and then we go through a critical appraisal?” They said, “Absolutely. Go for it.” So, I restructured that. I set up a Core Curriculum committee, in charge of what topics are discussed in our core lectures, in our grand rounds and mapped them to ACGME requirements. Did a lot of the fellowship nuts and bolts of education, and journal club. We survived a site visit for fellowship by ACGME. Now they do NAS, Next Accreditation System, so it’s a constant, ongoing process.
When Dr. John Bond retired in 2012, the section was down to three people. They chose me to lead the section. It was a tough year because I was still running the fellowship program and I had just had my first child. Not knowing very much about the section, and having people who were much older and far more senior than me, was very challenging.
I also had a VA career development award. So, technically, 75% of my time was supposed to be protected for research, but we were short-staffed, and clinical needs had to be met. Eventually, I cut back on my time from the university, and I stopped doing endoscopy there. Then, I transitioned the Associate Program Director position to someone else. I still remain heavily involved, even today, I still run the journal club and the core curriculum, but at least I could get away from some of the tedious and more administrative tasks.
I took on a whole new set of administrative responsibilities as Division Chief. The first goal was recruitment because we were so short staffed. The second goal was, of course, making the endoscopy unit more effective in terms of doing more cases, having fewer no-shows and cancellations, and assisting patients who have transportation issues or need an accompanying adult.
I remain very close with my university counterparts. Most of my research is at the university. My VA career development award is using data from a private practice here in Minneapolis, because I needed a large database of colonoscopies. For career development, I got a VA Merit grant to look at long-term outcomes after colon cancer screening, and I wanted to use the Minnesota Fecal Occult Blood trial data, which was the original colon cancer screening trial done at the university. I finished the CDA, which resulted in a highimpact publication in Gastroenterology (Gastroenterology 2015;149:952-957). I finished the Merit Study, which was published in The New England Journal of Medicine (N Engl J Med 2013;369:1106-1114).
As a Section Chief, who now has two children, how do you balance your research time, clinical responsibilities and administrative time?
AS: Clinical responsibilities always trump everything. Being the Section Chief, I actually end up doing more of it. So it’s never a neat ratio where I can say, every week, two days I do this, two days I do this. If it averages to 50/20/30 ratio—50 research, 20 clinical, 30 administration, that would be a good week. That is what I strive for. But, there are some weeks where it’s all clinical. Close to grant deadlines, I try to carve out a lot of time to work on grants. Then, when you have JAHCO visits, or other directives come down, or some other issue happens in the endoscopy lab that consumes your time.
Unfortunately, a lot of stuff trickles into home time. If I didn’t get through all my alerts, then I am logging in at night. Or if I didn’t get to all of my emails, or some academic or administrative stuff I have to do, review a grant or something, then I will do it from home. There are only so many hours, so that work typically happens after you put the kids to bed. I do try not to do that. I try to plan my week ahead of time. But, then, I expect the unexpected.
Absolutely, and the older the kids get, the later their bedtime, so the shorter the amount of time you have to get work done before you go to bed.
AS: Yeah, exactly.
For other ACG members who may be interested in taking on a leadership position, such as being a Section Chief or Chair position, do you have any recommendations on how to prep for this type of leadership position?
AS: If you have an interest and an aptitude, those are the two things that have to match up. That’s pretty much all you need, and then you have to let your interest be known. It may be intuitive to you, but it’s not intuitive to your Section Chief that you could be the next Section Chief or Associate Chief. Then people notice you for your thoughtful comments at staff meetings. You need to take ownership of the section and say, “I see this as a way we can make things better.” If you think you truly want that kind of a role, you should let your Section Chief and the Chief of Medicine know about your interest so they will groom you for the position, if it’s a good section and they are invested in your success.
